EP.WE.334Value of including CT chest in the management of acute abdominal emergencies: Experience during first wave of COVID-19 pandemic at a District General Hospital

Abstract

AimsThe aim of this retrospective study was to assess the incidence of positive findings on CT chest in patients presenting with acute abdomen, who underwent CT thorax as part of the Intercollegiate General Surgical Guidance on COVID-19 during the first wave. To correlate CT chest findings with confirmed cases on RT-PCR; and to determine its influence on surgical management of abdominal emergencies.MethodsA retrospective observational study of adult emergency surgical referrals (excluding trauma) for acute abdomen over a ten week period was performed. COVID changes on CT Chest were categorized as per the BSTI CT reporting criteria. Patient demographics, COVID RT-PCR, management and outcome were recorded. Statistical analysis was performed using Microsoft Excel with p value significant at ≤ 0.05.ResultsOf the 160 patients included, only 111(69.38%) had COVID RT-PCR. Of 24 (15%) patients with CT chest features of COVID, 45.83% demonstrated classic/probable CT features of COVID of which 36.36% had positive RT PCR. 54.17% had indeterminate pattern and none tested positive for COVID. There was a significant association between positive CT abdomen with normal CT chest findings (p = 0.03). Of 25 (15.63%) patients with normal CT abdomen, 7(28%) had CT features of COVID. Only 43(34.4%) patients needed surgical intervention of which 18.6% had COVID changes on CT, confirmed by positive RT PCR in 12.5%.ConclusionsCT chest as an additional investigation modality in acute abdomen had clinically helped in triaging of patients to appropriate specialties but did not influence emergency surgical management.